Stone Millicent, Warren Robert W, Bruckel Jane, Cooper Daniel, Cortinovis Daniela, Inman Robert D
Staff Rheumatologist, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada.
Arthritis Rheum. 2005 Jun 15;53(3):445-51. doi: 10.1002/art.21174.
To compare functional outcome of patients with juvenile-onset ankylosing spondylitis (JoAS; defined as AS with symptom onset before 16 years of age) with that of patients with adult-onset AS (AoAS) and to identify variables associated with a poor functional outcome of JoAS.
A cross-sectional study was performed of 326 JoAS patients who participated in a postal survey conducted by the Spondylitis Association of America. This cohort was compared with 2,021 AoAS patients who participated in the same survey. Simple and multiple logistic regression analyses were performed to identify differences with respect to clinical features, demographic features, and functional outcome (defined by the Bath Ankylosing Spondylitis Functional Index [BASFI]) between the 2 groups. A validation cohort of 255 AS patients was also surveyed.
The mean +/- SD BASFI score (controlled for disease duration) for JoAS was 51.3 +/- 1.5 compared with 46.4 +/- 0.6 for AoAS (P < 0.0001). Multiple logistic regression identified only age (P < 0.0001) and income status (P < 0.0001) as factors associated with functional impairment.
It appears that JoAS is a progressive disease and is associated with significant delay in diagnosis and worse functional outcome compared with AoAS. Furthermore, women do worse than men with JoAS. This would argue for the importance of early diagnosis and treatment of AS, particularly in the subgroup of patients with JoAS.
比较青少年起病的强直性脊柱炎（JoAS；定义为症状发作于16岁之前的强直性脊柱炎）患者与成人起病的强直性脊柱炎（AoAS）患者的功能结局，并确定与JoAS功能结局不佳相关的变量。
对326例参与美国脊柱炎协会邮政调查的JoAS患者进行了一项横断面研究。该队列与2021例参与同一调查的AoAS患者进行了比较。进行了单因素和多因素逻辑回归分析，以确定两组在临床特征、人口统计学特征和功能结局（由巴斯强直性脊柱炎功能指数[BASFI]定义）方面的差异。还对255例强直性脊柱炎患者的验证队列进行了调查。
JoAS的平均±标准差BASFI评分（校正疾病持续时间后）为51.3±1.5，而AoAS为46.4±0.6（P<0.0001）。多因素逻辑回归仅确定年龄（P<0.0001）和收入状况（P<0.0001）为与功能损害相关的因素。
JoAS似乎是一种进行性疾病，与AoAS相比，其诊断明显延迟且功能结局更差。此外，JoAS女性患者比男性患者情况更糟。这表明强直性脊柱炎早期诊断和治疗的重要性，特别是在JoAS患者亚组中。
